Heard on the Hill: APTA Policy on Concussion Management

A new APTA podcast highlights the increased attention that concussion management has received during recent years in the media and at federal and state policy levels.

"While the momentum created by the enactment of these new state laws marks a significant improvement in the recognition of this important public health issue, it also presents a reason for concern," says Nate Thomas, PT, DPT, MBA, associate director of APTA's federal government affairs. "Legislative and policy efforts at the state and local level on concussion management have been highly inconsistent, particularly in the guidelines for management and return-to-play decisions. Politically-driven efforts to make the treatment of concussions an exclusive, discipline-specific practice can be detrimental to an athlete's access to qualified health care professionals and the quality of care necessary to address the complexity of concussion injuries."

Thomas also reviews APTA's official position statement on concussion management adopted by the House of Delegates in June and discusses the Protecting Student Athletes From Concussions Act (HR 469), federal legislation that would facilitate the development of concussion management guidelines by school systems to address the prevention, identification, treatment, and management of concussions in school-age children. The guidelines outlined in HR 469 explicitly include physical therapists as one of the health care professionals in the concussions care management team.

Comments

Any licensed medical provider who is qualified should be able to participate in the process. Unless a CT/MRI scan is indicated, there is no reason a PT should not be able to evaluate a player based on current standards or examination and determine whether the athlete should play, sit, or be referred for more detailed examination including imaging.

Posted by Leon Richard
on 9/16/2011 2:57 PM

Here in Washington we passed the Zachary Lystedt Law in 2009 which many states and the NFL are using as model legislation. It specifically allows only 5 entities to make return to play (RTP) recommendations for athletes w/suspected concussions..MD/DO/PA/ARNP and ATC. I do not disagree w/Mr Leonard on the subject but you certainly need some definition of "licensed medical provider WHO IS QUALIFIED". Does this include chiropractors, massage therapy practitioners, naturopaths,etc, etc? These providers should be aware of any state legislation that might be in effect, their state Interscholastic Athletic Association's guidelines and familiar w/the findings and consensus statements from the International Conferences on Concussion in Sports (Vienna, Austria 2001/Prague,Czech Republic 2004/Zurich, Switzerland 2008) especially their 5 step recommendation for RTP and the use of the SCAT 2 as a screening/evaluation tool.

Posted by David Knoeppel
on 9/17/2011 1:13 PM

I am not in disagreement with Mr Knoeppel's response. However, I would state that anyone "qualified" would most certainly be well-versed in SCATs and the various criteria established for RTP decision making.
My question for him regarding the "definition" of licensed medical provider is this. Anyone with the acronym "MD or DO" after their name can do open heart surgery or brain surgery. That's the only "requirement" legally. There is no definition needed for who does those procedures or determines whether they're needed or not.
Chiropractors, massage therapists, naturopaths, are not "medical providers"... They never had the medical training, nor does their scope of practice include making those assessments and determinations in a medicolegal situation.
Every provider should know their state's licensing regulations and scope of practice. They should also seek to remain within those at all times.